Cosmetic outcome and patient satisfaction following percutaneous thermal ablation of early-stage breast cancer; results of an open label randomized phase 2 trial

Purpose: The aim of the present study is to assess patient reported cosmetic outcome and satisfaction following percutaneous thermal ablation and subsequent breast-conserving surgery.

Methods: Cosmetic outcome and patient satisfaction were assessed in postmenopausal women diagnosed with unilateral invasive cT1N0M0 breast cancer who participated in a randomized phase 2 treat-and-resect trial comparing the efficacy of radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation (CA). Cosmetic outcome was measured subjectively with the BCTOS-13 and the Beast-Q questionnaires (0–100 score), and objectively with BCCT.core software at baseline, after thermal ablation and after surgery. Patient satisfaction was defined as satisfaction with the technique (4 point scale), recommendation of the technique to others (yes/no), and the preference for surgery of thermal ablation after completion of both treatments.

Results: Forty-one patients were included in the study. The overall median cosmetic outcome was good after thermal ablation, and intermediate after surgery (1.6 vs 1.8; P = 0.07). Most domains of the BREAST-Q were scored higher after thermal ablation, 95 % of patients were very satisfied or satisfied with the technique, and 91 % would prefer thermal ablation over surgery. Differences between the different techniques were limited On the BCCT.core, 94 % of cases were rated as good or excellent after thermal ablation, compared to 80 % after surgery.

Conclusion: The present study demonstrates that patient reported and objectivated cosmetic outcomes are good both after thermal ablation and breast-conserving surgery. Patient satisfaction was outstanding following thermal ablation, with a preference for thermal ablation observed in a group of patients who underwent both treatment options.